Sobriety 24/7: results are in.

RAND study shows that twice-daily breath tests with the threat of short jail terms for continued drinking can keep repeat-offender drunk drivers and wife-beaters sober and out of trouble. That’s good news! Congratulations to Beau Kilmer, who did the research.

The myth that only something called “treatment” can help people with drug problems is dying hard, but it’s already fatally wounded. Treatment is beneficial to those who want it and will stick with it, but it’s neither a necessary nor a sufficient condition for recovery.

Comments

  1. says

    So what’s the longterm prognosis for people in such programs? Considering the alternatives, there’s nothing necessarily wrong with the idea that monitoring will go on indefinitely, just as long as policymakers and funders are aware of that.

  2. John Beaty says

    This is excellent news. Mark, do you think the results would extend to drug abusers (meth, heroin)?

  3. Don says

    When I was taking care of addicts, the clinical evidence showed that people forced into treatment did about as well as people who voluntarily entered treatment. That was a long time ago. Are there newer data to support the opposite view?

  4. Ralph says

    Just last night I watched a UW lecture on how length of various treatments was often negatively correlated with efficacy (that is, shorter was better or no worse than longer) for substance abuse AND other targets of behavior modification programs. Why? Why? kept asking the presenter. His punchline: desire for change often originates from within. If someone is not ready to change, a 3 month program may not out perform a 2 week program. Seems like common sense, no?

  5. Steven B says

    This is exactly my experience over years of delivering drug treatment to adjudicated clients – almost entirely worthless, except in rare cases of immanent motivation. To John Beaty – check out Project HOPE in Honolulu with meth addicts (studies available on the website). Mark has discussed HOPE at length on this site and in his books. The testing/confinement regimen works, with persistent alcohol misuse and meth addiction, both long and short term. Substance dependence is a behavioral condition, nothing more, nothing less, as delineated in Heyman’s “Addiction: A Disorder of Choice.” Project HOPE and 24/7 Sobriety seal the deal on this. Heavily reinforced behavior responds to…wait for it…behavior reinforcement and extinction. Doesn’t fit nicely with one hundred fifty year old ideologies, but there it is. We CAN reduce dangerous illicit drug use to levels near other industrialized countries, but only if we lose the moral and characterological judgment inherent to almost all “treatment” and shift to behavioral modification. Of course, this challenges a number of very large, entrenched, and profitable entities. Not to mention fundamental myths of American identity. Meanwhile, people suffer (and die).